Breathwork

You inhale for four counts, hold for seven, and exhale for eight. The long exhale and the extended hold slow your breathing rate substantially. A 2022 study of 43 healthy adults aged 19 to 25 found measurable immediate effects: heart rate and systolic blood pressure dropped in both groups, and in the non-sleep-deprived group high-frequency heart rate variability rose while low and very-low frequency power fell. That study measured physiology straight after the exercise rather than sleep or anxiety outcomes over time, and 4-7-8 was not included in the Stanford comparison trial.

Slow, gentle, exhale-focused breathing is safe for most people. The real risks sit with breath retention and hyperventilation. Never practise either in or near water, since hyperventilating before a breath-hold can cause loss of consciousness underwater without warning. Practise intense methods sitting or lying down. Lightheadedness and tingling are common and usually resolve by returning to normal breathing. Around one in ten participants in the Stanford trial reported a negative experience with the exercises, so disliking a technique is unremarkable.

No, though they overlap and are often practised together. Breathwork changes the breathing pattern to produce a physiological shift. Breath-focused meditation leaves the breath alone and trains attention on it. In a 2023 Stanford trial that compared them directly, five minutes of daily breathwork improved mood and lowered respiratory rate more than five minutes of daily mindfulness meditation, while both reduced anxiety.

Box breathing uses four equal phases: inhale for four counts, hold for four, exhale for four, hold for four. It is widely attributed to military training, which explains its reputation more than its evidence. Its two breath-holds make it a poor first choice for people whose anxiety includes air hunger or chest tightness, since holding the breath can reproduce those exact sensations.

Breathwork is deliberately changing your breathing pattern to change how you feel. It covers slow-breathing patterns like box breathing and 4-7-8, exhale-emphasised practices like cyclic sighing, and more intense methods built on hyperventilation and breath retention. The defining feature is that you alter the breath itself rather than simply observing it.

A double inhale through the nose followed by a long exhale through the mouth. It copies a reflex your body already performs spontaneously every few minutes to reinflate collapsed air sacs in the lungs. The second, smaller inhale reopens regions that had partly closed, which is what allows the long exhale to offload more carbon dioxide. Practised repeatedly for five minutes a day, under the name cyclic sighing, it was the exhale-focused practice the 2023 Stanford trial singled out.